Factors Associated With Acute Renal Graft Rejection in a Series of Transplanted Patients

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Background: The survival of renal graft is affected by the presence of acute rejection, so knowing the factors associated with acute renal rejection could eventually help develop a model of prediction of renal graft loss. Methods: An observational, case-control study, retrospective, was carried out in patients over 18 years of age, both genres who were Kidney transplanted. During the period from June 2015 to December 2016. Acute rejection was diagnosed by renal biopsy. A statistical analysis was carried out in SPSS v. 25 consisting of descriptive and inferential statistics using the X2 and t of independent samples as inferential tests and a multivariate binary logistic regression type analysis to determine the factors independently associated with acute renal graft rejection. A p<0.05 will be considered significant. Results: 134 kidney transplant patients of an average age of 30.7±10.4 years were included; 38.8% were female and 61.2% were male. The causes of kidney failure were indeterminate (82.1%), glomerulonephritis (3.7%), diabetes mellitus (3%), renal polycystosis (2.2%) and other (9%). 23.9% (n=32) had acute rejection in the first year after transplantation, the highest percentage of rejections occurred in the first 6 months. Patients with acute rejection had significantly higher levels of creatinine at baseline (1.8±1.5 mg/dL versus 1.2±1.1 mg/dL, p=0.016) and higher average of previous transplants (1.25 + 1.4 vs 1 + 0.2, p=0.002). The factors significantly associated with acute renal rejection in the bivariate analysis were: delayed graft function (OR=3.7, 95% CI 1.1-12.4) and a scheme other than Tacrolimus/Micophenolate/Prednisone (OR=7.4, 95% CI 1.3-42.6, p=0.026). In the multivariate analysis, the factors significantly associated with acute renal rejection were having had a previous transplant (ORa=6,354, 95% CI 1,867-21,627, p=0.003); and the use of an immunosuppression scheme other than Tacrolimus/Micophenolate/Prednisone (ORa=6,814, 95% CI 1,061—43,774). Conclusions: The factors significantly associated with acute renal graft rejection were delayed graft function, having had a previous transplant and the use of an immunosuppression scheme other than Tacrolimus/Mycophenolate/Prednisone. Funding: Government Support - Non-U.S.

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